Long-Term Outcomes of Prolonged Exposure and Naltrexone for Patients with Comorbid Posttraumatic Stress Disorder and Alcohol Dependence.

摘要

A growing body of research is examining effective treatment(s) for individuals with comorbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD). However, treatments for this comorbid population have been inadequately studied in the longer term. This study represents a long-term follow-up assessment of a randomized controlled trial that compared combined therapy (prolonged exposure + naltrexone) with monotherapies (prolonged exposure or naltrexone) for patients with PTSD and AD (see Foa, Yusko, McLean et al., 2013). Attempts were made to contact 120 participants 5-10 years after the original trial to assess the maintenance of treatment gains. Nineteen individuals were located and agreed to participate. A series of mixed ANCOVAs were conducted with PTSD symptom severity and percentage of days drinking and heavy drinking as the dependent variables. Findings revealed that reductions in PTSD symptoms and drinking behaviors generally were maintained 5-10 years after treatment. There was some relapse in heavy drinking days, and combination treatment was most effective for long-term PTSD outcomes. Challenges of conducting follow-up research with this population, implications and limitations of the present findings, and directions for future research are discussed.